| NPI | 1871049429 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY ELLEN ASHE Executive Director 716-913-5012 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery |
| Additional Taxonomies | 213EP1101X Podiatrist Primary Podiatric Medicine |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2018-08-07 |